Mastectomy

Excerpt

A mastectomy is a surgical procedure to remove all breast tissue. Various types of mastectomy exist based on the indications for surgery. A simple mastectomy, which is the most commonly performed procedure, involves removing all the breast tissue and the overlying skin and nipple-areolar complex (see Image. Total Simple Mastectomy). Variations of the simple mastectomy include a skin-sparing mastectomy with a significant amount of the skin preserved for reconstruction and a nipple-sparing mastectomy where the nipple-areolar complex and most of the skin overlying the breast are preserved. A modified radical mastectomy combines a simple mastectomy with an axillary lymph node dissection.

In contrast, a radical mastectomy, which is mostly of historical interest, involves the simultaneous removal of the chest wall muscles. Historically, mastectomy was the procedure of choice for breast cancer. With our improved understanding of breast cancer biology, advances in chemotherapy and radiation, and the knowledge that breast cancers are systemic diseases, more limited surgical procedures, such as partial mastectomies or lumpectomies, are now far more commonly performed. Mastectomy remains an essential adjunct to therapy and is still indicated in specific benign and malignant breast lesions. This article focuses on the anatomy of the breast, indications for mastectomy, and the conduct of various types of simple mastectomy.